Showing papers by "David C. Reutens published in 1991"
TL;DR: At the dose studied, intravenous lidocaine has, at best, only a modest effect in acute migraine.
Abstract: We performed a prospective, randomized, double-blind, placebo-controlled trial of intravenous lidocaine (1 mg/kg) in the treatment of acute migraine. Thirteen subjects were randomly allocated to receive intravenous lidocaine and 12 received intravenous normal saline. Subjects scored the intensity of headache and nausea on separate visual analogue scales before the injection and at 10 and 20 min after injection. At 20 min, the mean pain intensity score was 80% of initial intensity in the lidocaine group and 82% in the placebo group. The difference was not statistically significant; at 20 min, the 95% confidence interval for the difference between the two groups in mean percentage of initial pain score was 2 ± 29%. At the dose studied, intravenous lidocaine has, at best, only a modest effect in acute migraine.
35 citations
TL;DR: A case of neuroleptic malignant syndrome resulting from withdrawal of low‐dose levodopa therapy for mild Parkinson's disease is described.
Abstract: OBJECTIVE To describe a case of neuroleptic malignant syndrome (NMS) resulting from withdrawal of low-dose levodopa therapy for mild Parkinson's disease. CLINICAL FEATURES Treatment with levodopa, 50 mg, and benserazide, 12.5 mg, three times a day was withdrawn from a 76-year-old woman with mild Parkinson's disease because she was experiencing intermittent confusion. Fever (38.5 degrees C), tachycardia, increased confusion, severe rigidity and generalised stimulus-sensitive myoclonus developed after 12 hours. The creatine kinase level rose to 2058 U/L. INTERVENTION AND OUTCOME The fever abated with reintroduction of levodopa. Rigidity was slow to resolve and required additional treatment with dantrolene sodium. CONCLUSION NMS may be precipitated by withdrawal of relatively low doses of levodopa, even in patients with mild Parkinson's disease. Hyperthermia and rigidity in NMS may result from involvement of separate central dopaminergic pathways.
15 citations
01 Jan 1991
TL;DR: The clinical, radiological and electrophysiological features of 15 patients with intramedullary high signal intensity on spin-echo T2-weighted MRI scans and cervical spondylotic myelopathy were reviewed, and it is suggested that the response to decompressive surgery is likely to be incomplete in patients with intermodal change.
Abstract: The clinical, radiological and electrophysiological features of 15 patients with intramedullary high signal intensity on spin-echo T2-weighted MRI scans and cervical spondylotic myelopathy were reviewed. Intramedullary change was present at the site of maximum cord deformity. A further examination was performed at a median interval of 7 months after surgical decompression in 10 patients. In 8, little or no improvement in symptoms had occurred. Signs of myelopathy persisted in all patients. Abnormal central somatosensory conduction was present in all patients so studied after operation. Of nine postoperative studies, seven showed persistent intramedullary change. In 2 patients the T2 changes had resolved; symptoms had not improved in 1 and sensory disturbance persisted in the other. These results suggest that the response to decompressive surgery is likely to be incomplete in patients with intramedullary change.